NPI | 1033270863 |
---|---|
Entity Type | Organization |
Authorized Contact | CINDA L TYLER Clinic Administrator 541-440-6390 |
Organization Subpart ? | No |
Primary Taxonomy | 207Q00000X Family Medicine |
Additional Taxonomies | 207R00000X Internal Medicine |
208000000X Pediatrics | |
208D00000X General Practice | |
363A00000X Physician Assistant | |
363L00000X Nurse Practitioner | |
Enumeration Date | 2006-12-13 |
Last Update Date | 2020-08-22 |